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General NPI Number Information
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NPI Number | 1295944957
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Entity Type | Organization
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Legal Business Name | KHOSROW DAVACHI MD PC
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 7700 OLD BRANCH AVE STE D203
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City | CLINTON
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State | MD
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Zip | 20735-1611
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Country | US
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Telephone | 301-868-7121
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Fax | 301-877-1934
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Provider Business Mailing Address
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Address Line | 7700 OLD BRANCH AVE STE D203
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City | CLINTON
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State | MD
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Zip | 20735-1611
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Country | US
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Telephone | 301-868-7121
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Fax | 301-868-7968
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | DR. KHOSROW DAVACHI
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Credential | MD
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Telephone | 301-868-7121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | MD8172
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | D0025640
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License Number State | MD
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